Title Page

  • Inspector Name:

  • Date of Inspection:

  • Builder:

  • Project Number:

  • Subdivision:

  • Job Type:

  • Lot/BLDG Number:

  • Jobsite Location:
  • Jobsite Crew Leader

Safety/EPA/Vehicle/Storage/Tools

Safety:

  • Is sufficient PPE being used?

  • PPE being used:

  • PPE not used:

  • Names of those without proper PPE:

  • Caution tape being used?

  • Any unique hazards on this jobsite?

Storage

  • Are fuel cans being stored in a safe area?

  • Are high-valued tools being stored in a safe area?

  • Are all storage containers labeled?

Tools

  • Are all tools and cords in good condition?

  • Are all hand tools in a safe and usable condition?

  • Are all power tools in a safe and usable condition?

  • Are all cords in good condition (excluding power tools)?

EPA

  • Were all EPA guidelines followed?

  • Is the street dirty from the job?

  • Is there excessive concrete on the ground?

  • Is the jobsite cleared of excessive trash?

  • Is the slit fence present and/or in good condition?

  • Is the water pump being filtered correctly?

  • Was anything spilled?

Vehicle info:

  • Are Custom Concrete trucks present?

  • Was pre-trip inspection filled out?

  • Name of driver:

  • Is the box/bed damage?

  • Is the cab damage?

  • Does the truck have cones?

  • Are the cones being used?

  • Vehicle(s) ID Number:

Jobsite Info

Excavation Conditions

  • Excavation okay?

  • Proper sloping/benching?

  • What is wrong with sloping/benching?

  • Ramp and/or stairs in good condition?

  • Enough room between wall and excavation?

  • How wide is the path?

  • Is spoils pile at least 2' away from edge of excavation?

  • Name of excavator:

  • Soil Type?

  • Any potential cave-offs?

  • Conditions of drive onsite?

  • Does driveway onsite have enough room for full outrigger extension (27')?

  • Photo of jobsite:

Sanitation:

  • Is a portable toilet at jobsite?

  • Is portable toilet close enough?

  • How far away is it?

  • Is the portable toilet clean?

  • Last time it was serviced?

  • Does the portable toilet have toilet paper?

  • Last time it was serviced?

  • Are there enough portable toilets for the area?

  • Number of active jobsites?

  • Estimated number of workers in area?

  • Do workers have water onsite?

  • Is there enough water?

  • Is container being used clean?

  • Do workers have trashbag onsite?

Extra Notes

  • Anything else needing to be noted about jobsite?

  • Photo?

  • Anything else needing to be noted about jobsite?

  • Photo?

  • Anything else needing to be noted about jobsite?

  • Photo?

  • Anything else needing to be noted about jobsite?

  • Photo?

  • Anything else needing to be noted about jobsite?

  • Photo?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.